US doctors flee healthcare chaos

During a recent trip to Canada, I became more aware of why many doctors from south of the border were looking to move

Healthcare in the US has undergone seismic change since President Donald Trump took office. His Health and Human Services Secretary – Robert F Kennedy (RFK) Jr – got the job on the back of the dubious ‘Make America Healthy Again’ programme. A vaccine sceptic, RFK has taken some disturbing decisions since he assumed the role.

Experts have pointed to growing dysfunction within federal health agencies, attributing the instability to RFK’s leadership style and priorities.

One major flashpoint has been the abrupt cancellation of key public health initiatives by both the Food and Drug Administration (FDA) and the Centres for Disease Control and Prevention (CDC).

Notable casualties include the FDA’s annual flu vaccine advisory meeting and the CDC’s ‘Wild to Mild’ influenza awareness campaign – two cornerstone initiatives designed to shape seasonal vaccine strategies and inform the public. Their sudden discontinuation has raised serious concerns about the future of vaccine policy and the broader erosion of public trust in immunisation.

Healthcare leaders warn that dismantling public education campaigns risks fuelling rising vaccine hesitancy at a critical time. Their concerns have been amplified by RFK’s own rhetoric. He has publicly claimed that “there is zero evidence that the flu shot prevents any hospitalisations or any deaths”, and has asserted it makes individuals “six times more likely” to spread the virus. These statements are not supported by scientific evidence. In fact, a substantial body of research shows that flu vaccines significantly reduce severe illness and death across all age groups, particularly among young children and the elderly.

Simultaneously, the White House has intensified scrutiny of high-risk pathogen research. Under a new executive order from President Trump, the National Institutes of Health has instructed scientists involved in so-called “gain-of-function” studies to pause their work and revise protocols to minimise the risk of producing more virulent or transmissible pathogens. The directive is expected to seriously impact ongoing research into diseases such as tuberculosis, influenza, and Covid-19.

The fallout from all this is already having an impact on the frontlines. I’ve just returned from a family visit to Ontario, Canada, where I became increasingly aware of a number of doctors who were in the process of moving from the US in response to the healthcare upheaval.

A recent feature in KFF Health News was especially revealing on the subject. It was largely based on an interview with ‘Michael’, an emergency room doctor who was born, raised, and trained in the US. Now working in a small-town hospital in Canada, he was granted anonymity because of fears he might face reprisal from the Trump administration if he returns to the US.

He said America, in his view, had become increasingly desensitised to violence and cruelty.

“Part of being a physician is being kind to people who are in their weakest place,” Michael said. “And I feel like our country is devolving to really step on people who are weak and vulnerable.”

“Civil discourse was falling apart,” he added. “I had a conversation with my family about how Biden was going to be a one-term president and we were still headed in a direction of being increasingly radicalised toward the right and an acceptance of vigilantism.” It took roughly a year for him to secure Canadian medical licensing, with additional time to arrange his new role and relocate.

That transition, however, is becoming smoother for other doctors. Several Canadian provinces have eased licensing rules in recent years, making it easier for US-trained medical professionals to practise. In Ontario, for instance, recent regulatory changes allow American physicians to begin working in healthcare settings without first registering with the College of Physicians and Surgeons of Ontario. They can now practise for up to six months while completing the formal registration process – an important shift that lowers barriers to entry.

Interest from US doctors is surging. The Medical Council of Canada told KFF Health News that the number of American physicians creating accounts on physiciansapply.ca has jumped by more than 750 per cent over the past seven months compared with the same period last year, rising from 71 to 615 applicants. Meanwhile, medical licensing authorities in Ontario, British Columbia, and Manitoba have also reported increased numbers of US doctors applying for or receiving licences, with several applicants citing their disapproval of Trump-era healthcare policies as a driving factor behind their decision to leave.

American healthcare has never been equitable. But it looks like it is about to get a lot worse in the Trump years ahead.